Balance Disorders in Postural Orthostatic Tachycardia Syndrome (POTS)

Abstract

Background: Postural Orthostatic Tachycardia Syndrome (POTS) is a form of dysautonomia that is estimated to impact between 1,000,000 and 3,000,000 Americans, and millions more around the world. POTS is a form of orthostatic intolerance that is associated with the presence of excessive tachycardia and many other symptoms like Headache, Abdominal discomfort, Dizziness/presyncope, Balance disorder, Nausea, Fatigue, Lightheadedness, Sweating, Sleep disorder, Tremor, Anxiety, Palpitations, Exercise intolerance upon standing. AIM: The purpose of this research is to test the Balance disorders in POTS patients through Balance testing. Methods: 80 POTS patients were randomly selected from our clinic with dizziness, lightheadedness, presyncope, balance disorders and performed clinical test of sensory integration in all the patients. The testing done in four conditions with eyes open on firm surface, eyes closed on firm surface, eyes open on foam surface and eyes closed on foam surface. Sway index is calculated in all four conditions. Sway index with eyes open on firm surface < 0.50 is considered better, >0.50 is worse. eyes closed on firm surface < 1 is considered better, >1 is worse. eyes open on foam surface < 0.75 is considered better, >0.75 is worse.eyes closed on foam surface < 2.25 is considered better, >2.25 is worse. Results: Out of 80 POTS patients, 98% are females (n = 78, age 28.08 ± 9.09), 2% are males (n = 2,age 31.62 ± 11.62). Balance testing with eyes open 0.98 ± 0.71 (Worse in n = 61,76%); eyes closed 1.62 + 1.47 (Worse in n = 53,66%); eyes open on foam surface 1.47 ± 1.04 (Worse in n = 75,94%), eyes closed on foam surface 3.38 ± 1.49 (Worse in n = 59,74%). Conclusion: First time, our research study demonstrated that POTS patients have significant balance disorders with worse sway index in all four conditions in higher percentage of patients.